I'll be done in ten minutes.
This is my last one.
Okay, I'll text you.
Oh, we're live.
That's how we do this thing.
We're having side conversations.
That's how I'll text you.
I'll text you.
We'll talk later.
Growth doesn't have to mean chaos.
Our next guest has spent years helping
practice owners get back to basics,
building better connections,
simpler systems, and healthier businesses.
More is actually not better.
Sometimes less can be better.
Live again from Anaheim.
Welcome back to the show, Sturdy McKay.
Welcome back.
Thanks, Jimmy.
Where do we overcomplicate things?
Let's start there, practice owners.
Yeah,
well the first thing I wanna talk about
is I wanna call bullshit on social media
marketing.
Okay, good.
Okay, because right now PTs,
and this has been happening for probably a
decade, right?
PTs have been sold a bill of goods
by these marketing people,
many of whom are PTs,
who are charging them exorbitant amounts
of money to advertise on Facebook, Google,
all these things they can charge on
basically on a monthly basis to manage
their ads.
And people don't buy healthcare on
Facebook.
You know, it's just,
so there's this whole process of trying to
build trust and whatever.
And what I've been working with clients
lately,
a number of them go back to where
the patients are.
And, you know,
if we're going to focus on
musculoskeletal,
and the same thing's true, by the way,
if we do peds or neuro or you
name it, right?
But musculoskeletal,
half the people with a musculoskeletal
issue go to their primary care doc first.
So, you know,
if you kind of break it down a
little bit, what,
average primary care doc sees seventy to a
hundred visits a week.
Sure.
Twenty to forty percent of those
statistically are musculoskeletal.
What's their training with MSK?
Lacking.
Yeah, I mean, they got two tools, right?
They got pills, and they got surgeons.
And the pills,
we all know what happened with that,
right?
And then with the surgeons, right,
people are waiting six weeks,
twelve weeks, sixteen weeks, months,
literally, to get in,
only to then be sent to PT.
And we've known this for years and years,
right?
The Virginia Mason study was long ago and
showed that if we change the clinical
pathway, it saves money,
it gets people better faster,
it benefits everybody.
But we've gotten away from this because of
kind of the marketing.
And by the way,
I didn't even say this,
but those same marketing people are
telling practice owners to spend,
you know,
five to ten percent of their revenue on
marketing.
And that's insane.
That's like half their profit margins.
And it's all gone to do what?
And very,
very few people are tracking how many
patients they're getting from.
You brought this up before.
Yeah, it's kind of crazy, though.
So the big thing is there's a hidden
patient volume in primary care.
They're sitting in the waiting room down
the street from you.
And the algorithm,
you've got to figure out it's not
Instagrams.
It's how to work that whole relationship.
A relationship.
Absolutely.
Yeah.
That's what it should be.
And the good ones are, you know,
I've talked to a few people that are
like here at CSM, right?
Who are like, yeah,
we don't like to market to doctors and
stuff.
Like what's your most powerful marketing
channel?
Like for any practice owner or any
business, right?
We're sitting in the USPH booth.
Any business, it's word of mouth.
Okay,
so how many people does your current
patient sitting in front of you know that
could use your help this week?
One, two, three.
Really?
They know twenty they could tell?
Oh, could they tell?
No.
Should they?
Yeah, but I mean, but that doctor is,
right?
They're there asking for help.
They're going to them for help and they're
not getting the help they need.
And it's costing a ton of money in
the system.
It's, you know, again,
it's a treasure trove of patients who are
not happy, right?
Because if I got to wait three months
to see the orthopedic surgeon and only be
told I'm not a surgical candidate and I'm
going to go to PT,
then you're sitting there going, well,
why didn't they tell me that in the
first place?
This is a relationship game.
It's people on one side,
people on the other side.
I mean, I don't wanna oversimplify it,
but.
It's not that complicated.
You know,
and when people talk about physician
marketing,
So don't market to physicians,
but build a relationship.
Exactly.
If you treat it like marketing,
it's going to feel like marketing.
It's going to taste like marketing.
It's going to smell like marketing.
These are not stupid people.
And even when we're not standing in an
expo hall filled with a bajillion booths,
you're still exposed to hundreds or
thousands of marketing messages a day.
We're trained to ignore those things.
Right.
So the bar isn't low.
The bar's on the floor in terms of
doing something differently.
When the world goes digital and advanced
and AI, go the other way.
Go handwritten note.
Chad Madden said this.
He goes,
you're not going to like my first three
answers of what to do to improve your
marketing.
It's going to be handwritten notes at the
end of every day.
It's going to be calling your patients
from six months ago and say,
honestly asking how you doing right like
it's not sexy right uh but we're not
doing the same thing with the doctors
right and the correct note is super
important and i'm a big advocate of that
and you know you know how think about
this when's the last time you got a
handwritten thank you note i do not know
when do you think the last time that
doctor got a handwritten thank you note
from another provider or when did he get
a you know a panera lunch
shipped in that they're like,
I see what this is.
And you telegraph this and try to buy
me.
And no offense, man,
I'm worth more than a few Panera,
you know, paninis.
So much more.
I mean,
what the primary care docs in particular
are looking for is happy patients.
Correct.
Right.
Because people are in pain.
They're complaining.
They got away.
They're calling.
They're coming back.
I'm not better yet.
It's just a constant drain and emotional
suck on their day versus you do a
great job with your patients, you go back,
the patient goes back and tells the
primary care, they were wonderful.
They solved my problem.
Right.
And you're like, great,
now I've gotten this person.
I am a resource.
Right.
And again,
if they're seeing like twenty people or so
a week that could be using your help,
why can't they see you too?
Correct.
So what does the back to basics approach
look like?
Well, it's just what you said.
It's just developing relationships.
There's a lot of more upfront work in
the beginning with that,
but I had somebody reach out and say,
what do you do for your wow baskets?
I'm like, I don't do a wow basket.
That's kind of like love bombing somebody
or taking them on a helicopter ride for
the first date.
It's creepy.
What do you do after that?
Yeah, what do you do after that?
Right.
So no,
I told her I would take whatever you
have in your wow basket and I would
divide every one of those things up and
drop them off one a month.
You know, one little thing like, I mean,
the research even shows with
relationships,
it shows us in the workplace,
it shows it multiple places,
but small tokens,
small effort consideration.
That's what builds relationships.
Yeah.
Make it specific.
I love this one.
The more specific, the more terrific.
Right.
make it specific to them, listen to them.
This is why you want to keep track
of these relationships.
You want to write down, you know,
their spouse's name.
You want,
if you can find out in conversation,
their anniversary, you write it down.
Don't force it though.
No, no, no.
But if it happens,
write it down because that serves as your
longterm memory.
Right.
And then, you know, their kids like,
do the kids like, well, here, Dave Kittle,
right?
He's a client of mine.
I, I had,
cause Dave's a big Phillies fan, right?
I had queued up before Christmas a glove,
a ball,
and a hat for his little baby, Davey.
Because he just had a baby.
Right.
Davey's like eight months old or
something, right?
And I'm going to send him Phillies
baseball stuff.
I found out in order to get his
kid named Davey,
he had to agree that he was allowed
to be a Mets fan,
not a Phillies fan.
Oh, man.
But I was about to click no.
And you changed it.
And I would have sent him Philly stuff.
And just by saying, hey, you know,
I know Dave likes baseball.
You love baseball.
Is he a Phillies fan?
He's like, no.
And he tells me the whole story.
I'm like, ooh, okay.
So he got, yeah,
but he got Mets stuff.
But I remember that now, right?
And then, you know, he's happy.
And again...
We're talking about small tokens.
That wasn't an expensive gift.
Can I tell you one that works pretty
well because it's real?
I did a little bit of research on
a potential client that I was trying to
get to build a relationship and saw that
they shared a particular charity.
So I was like, hey,
I just want you to know I made
a fifty dollar donation in your name.
It's huge.
And because fifty dollars
isn't enough to,
it just feels transactional.
But I did this thing, and there's no,
for it to be a gift,
there has to be no expectation of return.
We forget that.
Well, I bought you a basket,
when are you gonna send me patients?
That's no longer a gift,
because there's an expectation.
So hey, listen,
I saw that that charity is meaningful to
you.
I made a donation, because you know what?
They all deserve the money,
and I just wanted to let you know
that I saw you,
and I saw that that was important to
you.
And that meant something.
That's an emotional impact, again,
for not a huge lift.
to do that kind of thing.
And those things,
that's the beauty of the relationship,
right?
To get it started.
It's one thing,
but then to keep it going,
you just have to keep being interested.
You have to keep being curious to keep
asking questions, learn about them,
and then do little things that, you know,
reinforce that, that let them,
like you just said, I see you,
they've been seen.
show not tell.
I'm really interested in you is a weird
way to say it, and it's transactional,
but hey,
I really appreciate you did that thing.
I was giving a talk to students a
couple weeks ago, and they said,
How can we be seen as an authority?
And I said,
do you want to know how to look
interesting?
Be interested.
Like, honestly, though.
Right.
Because people can tell when it's a fake
question or you're doing it for a
transact.
We are.
Nobody taught us how to smell out fake,
but we can.
We just can't.
We're wired for it.
Because, again, if I'm just trying to.
This is all the salespeople.
Right.
I'm just trying to close a deal.
it feels way different from,
can I help you solve a problem?
No big deal if it's not the right
time.
It's a totally different vibe.
In order to do that though,
we got to track it.
That's the other thing.
I haven't even shown you that,
but I built that.
What is this?
Sixer HQ.
It's just relationship tracking.
referral relationship management, right?
I'm kind of focusing in on ortho
initially,
just because we know that's where the
patients are.
But it's not, it's like a CRM,
but without all the sales pipeline stages.
You know, it's kind of after the close,
if you will, except that there's no close,
right?
Because the relationship shouldn't have
a... Right, doesn't have a close date.
Right, right, right.
Doesn't even really have like, oh,
we're now, you know,
you're not getting engaged to the doctor.
It's not a monogamous romantic
relationship or anything like that, right?
Right.
You're just like, but you're,
you're connecting and you're helping each
other and you truly are.
And I, you know, I love this too.
I've had back when I was running the
practice and in the practice, you know,
we're sitting at happy hour with five
surgeons and a couple of fellows and
stuff.
And they're like, how do you do marketing?
I'm like, whoa,
I'm here with six of you or seven.
You guys just invited me to happy hour.
Correct.
Yeah, that's the goal.
Yeah,
and here's my little daughter and
everybody's talking.
Yeah, it feels more natural than it is.
So who's this for and what do they
gain from it?
Oh, so it's four practice owners,
it's really any practice,
we can go bigger too,
but who relies on referrals or wants to.
And they want to do it better.
Yeah,
and they want to make sure they're not
dropping the ball.
I talked to somebody who has twenty-two
clinics, three regional marketing people,
and he's founder and CEO and he doesn't
know what they're doing on a daily basis.
I'm like, well,
this gives you transparency into the
activity.
And yeah, they told you they went there,
but did they?
Just trust and verify all that.
So there's the visibility,
there's the continuity.
But yeah,
and really it's for any specialist.
It could be orthodox,
it could be pain management,
it could be anybody who relies on
referrals.
And that brings up another one,
like back to that whole social media
thing.
The same people I was talking to is
like, I asked, do you rely on referrals?
Like, well, yeah, about ninety percent,
but I know we shouldn't.
Like, why not?
Right, back to the word of mouth.
Why not?
Now,
it shouldn't be ninety percent with one
doctor.
Right, right, right.
Right.
But if you have a big,
broad panel of physicians all over the
network, you got it right.
A network of people you have relationships
that you are a solution for.
Right.
And it's more complicated.
You've got to keep track of more stuff.
You've got to keep up with it.
Yeah.
You don't want all your eggs in one
basket at the same time.
Having a broad referral network.
that there's absolutely nothing wrong with
that.
I think we've gotten away from that over
the past decade or so of being filtered
into doing all this.
When the world goes digital,
You can go into an arms race and
if I'm going to outspend, outspend,
outspend,
that's a race not to the top but
to the bottom.
When the world goes digital, go to analog.
Listen, kids, at one point,
bell bottoms were the coolest thing in the
world, and then they weren't,
and then they were again,
and then they weren't again.
And you know what?
In a couple of years,
my money is on bell bottoms showing up.
Maybe not as big as the sixties,
but they'll come back.
Right.
So you use technology for the right
things, right?
Sure.
Staying up to speed and stuff.
But then, yeah, dude, handwritten notes.
Here's another one for everybody out
there.
If you're sending a report to a doctor
or to anybody,
write one handwritten sentence on it.
Right?
Because we are like just psychologically
programmed.
If I had hit something handwritten on
here, you would read it first.
Right.
Someone, right.
This was added after the fact.
Someone wrote on a printed document.
This is the important thing.
Right.
The brain craves novelty.
Right.
If I see something fifty times,
I'm going to start to ignore it.
You get all these reports all the time,
whatever.
Got it.
It has like, hey, thanks for the referral.
She's going to do great.
Jimmy, they're going to read it.
Yeah.
They can't not read it.
Like they're compelled to read it.
Why is this difficult for people in
healthcare?
Is it because we are very formulaic and
if you tell us,
this is how it's done, do this,
do A plus B, we get C,
and humans are messy and that's harder?
That's a great question.
I think so much of it does have
to do with we're good at the things
we're good at.
It's a classic e-myth business owner
story, right?
I'm really good at plumbing.
I don't like talking to customers.
Well,
when you opened your plumbing business,
you signed up to talk to customers, right?
You signed up to manage people.
You signed up.
So when you opened your clinic and stuff,
you became a marketer,
whether you wanted to or not,
whether you were aware of it or not.
Yep.
Brother Basil,
I went to a Catholic university for
college,
and he stood up in the first day
of public relations, and he said,
what's public relations?
You're in public relations class.
We're going to define it.
What's public relations?
And I was smart enough to know he's
a brother,
so he's wearing the robe and the rope,
and I'm like, this is a trap,
so I'm going to keep my mouth shut
because this is going to be a suddenly
simple answer, not a come.
But people were trying to,
it's spin and story control, and I'm like,
this is a trap,
but keep your mouth shut.
And once everybody ran out of air,
he was like,
public relations is building a
relationship with the public.
Answers in the question.
It's building a relationship with the
public.
And he said the other sentiment was you're
either doing public relations well or
poorly.
There's no not doing it.
Not doing it is doing it poorly.
The muscle was atrophying or
strengthening,
but it's never just sort of staying the
same.
It's in one direction or not.
And you're what people know about you.
I love those like.
the house by driving,
and then people will take pictures of
that.
I'm like, that's public relations, man.
If your guy is out there acting like
a jackass,
he's doing public relations for you on the
road in your van.
It ain't good.
It's anti-public.
It's a bad public relations,
but it is PR.
Right, right.
No, you're dead on.
What's something someone who's a practice
owner is probably overlooking right now
that they could do tomorrow without
spending a dollar that will help them do
all the things we're talking about?
Well, again,
write a little thank you on the report
that you're printing and sending anyway.
If you want to spend a dollar,
write on a thank you card,
just a fold card and stick it in
an envelope and mail it.
But send a thank you to somebody.
You know,
and that's not a bad practice for any
business owner to sit down every week,
every month and just think,
who do I owe a thanks to?
Because one of the things that I ran
into early on, somebody asked me,
you know,
out to lunch and she wanted to ask
about, you know,
starting a business and all this.
And I told her, you know,
one of the things I've learned in the
first few years was,
ironically never more dependent upon more
people over whom you have no control than
when you start a business yeah and you
know you're depending on the landlord and
the supplier and the employees and the you
know customers and the bank and like all
these dependencies and basically the part
part of this is somebody did something
nice for you this week have you told
them say thank you yeah it's that simple
and it's super easy to forget right you're
mired down you're busy you're stressed out
It's super easy to forget, but that two,
five minutes.
Leaves a mark.
And it's huge.
Again, back to when's the last,
or call them and say,
like when's the last time somebody called
and just said, hey,
I just want to reach out and say
thanks.
That was really helpful.
And then the funny part is they're almost
waiting for the sale.
And when you don't give it, that's huge.
When you're like, no, that's it.
That was awesome and I appreciate it and
I wanted you to know that.
And I didn't have a chance to say
it when it happened, but thank you.
It's a pattern interrupt, what we call.
It doesn't happen every day.
So by doing it and taking forty five
seconds to do it,
it carries weight as it should.
Again, make sure it's real, though.
Absolutely.
You can't fake it.
If you fake a relationship,
it's going to blow up.
Yes.
Eventually, it will come to light.
Last question I'll ask.
What gets lost when growth becomes the
only goal?
I need to get bigger.
Growing.
What gets lost?
What do you lose along the way?
I think it's a super simple answer,
and it's our humanity.
We get so caught up in the data,
the numbers, the push, the whatever,
trying to make payroll,
trying to keep all the balls in the
air.
And we just forget that we're dealing with
other people.
And, you know,
it's really easy to look at numbers and
say, well, they're not performing.
They're not doing it and start to get
angry and blame and all that without just
saying, you know, hey,
I noticed things aren't going so well.
How's it going?
Yep.
What can I do to help?
Yeah.
All right.
We have Tristan on the show.
You've done it before.
We call it.
Is there anything else we wanted to hit
you?
No, I've got my parting shot.
Here it is.
The parting shot.
This is the parting shot.
One last mic drop moment.
No pressure.
Just your legacy on the line.
Parting shots.
Sturdy McKee, what do you got?
All right.
So Thomas Edison said,
the doctor of the future will give no
medication but will interest his patients
in the care of the human frame, diet,
and in the cause and prevention of
disease.
And, dude, that's physical therapists.
Yeah.
We're here.
Here we are.
Right here.
Fifteen thousand of us.
Sturdy,
where do you want people to go if
they want to look you up?
Oh,
you can Sixer HQ or Sturdy Coaching or
you can, I mean,
I'm not hard to find on LinkedIn or
anywhere.
Sturdy McKee.
Love it.
Well,
I'm not hard to find in a red
bow tie.
Thanks for coming on live here at CSM.
Thank you.